补益心脾法对产后抑郁症患者中医证候积分以及雌、孕激素的影响

目的对以补益心脾法组方的中药进行产后抑郁症的疗效评价及安全性分析,进一步明确中医药治疗抑郁症的疗效、优势及安全性。方法产后抑郁患者属心脾两虚的患者60例,均来自北京中医药大学第三附属医院及其下属的3个社区,随机分为治疗组30例及安慰剂组30例。治疗组采用参芪解郁颗粒,1剂/d;安慰组采用淀粉糊精颗粒,1剂/d,2组疗程均为6周。分别于治疗前及治疗后1周、2周、4周、6周,应用抑郁症中医证候评分量表进行疗效评定,同时测定治疗前后血清雌二醇及孕酮水平。结果中医疗效指数评估临床疗效:治疗组总有效率为86.67%,临床控制率26.67%,安慰剂组总有效率为73.33%,临床控制率10.00%;2组在治疗2、4、6周时的中医证候减分率差异均具有统计学意义(P0.05)。治疗组及安慰剂组治疗后雌二醇水平均有上升趋势;治疗6周后,治疗组及安慰剂组与自身治疗前相比有统计学意义(P0.05),治疗组疗效优于安慰剂组(P0.05)。治疗组及安慰剂组治疗后血清孕酮水平均有下降趋势,治疗6周后,治疗组及安慰剂组与治疗前相比有统计学意义(P0.05)。治疗组与安慰剂组疗效无统计学差异(P0.05)。结论应用补益心脾中药参芪解郁方对产后抑郁心脾两虚证患者进行治疗,能够有效改善患者中医证候评分,降低血清孕酮水平,显著提升血清雌二醇水平,具有起效快、副作用小等优势。

Effects of method of nourishing heart and spleen on estrogen,progestin and TCM syndrome score in patients with postpartum depression

Objective To evaluate the efficacy and safety of Shenqi Jieyu formula (SQJYF),a Chinese medicine compound formulated by the method of nourishing heart and spleen,on patients with postpartum depression (PD),so as to provide more evidence for Chinese medication treatment no depression. Methods Altogether 60 PD patients with the syndrome of deficiency of both heart and spleen from the third affiliated hospital and three communities were included,who were randomly divided into treatment group and placebo group (n =30 each).The patients of the treatment group were taken orally SQJYF one dose daily,while patients of the placebo group were taken starch particles at the same dose for consecu-tive six weeks.The efficacy was assessed by using TCMDepression Scale as well as measuring serum es-trogen,progestin before treatment,at the first week,second week,fourth week and sixth week of treat-ment.Results The total effective rate of treatment group was 86.67%,while 73.33% of the placebo group;the clinical control rate of treatment group was 26.67% to 10.00% in the placebo group.There was significant difference in decreasing rate of TCM score between the two groups at the second week, fourth week and sixth week after treatment (P <0.05).The serum levels of estrogen both increased in two groups.There were significant difference between before and after treatment of each group,and the serum estrogen in treatment group was higher than that in placebo group(P <0.05).The serum levels of progestin both decreased in two groups.After six-week-treatment,the levels showed significant difference between before and after treat(P <0.05),while no difference was proved between the two groups(P >0.05).Conclusion SQJYF had the advantages of rapid onset and less side effects by decreasing TCM syndrome scores and the serum level of estrogen,and increasing the serum level of progestin,on PD depression patients with the syndrome of deficiency of both heart and spleen.